Recovery From an At-Risk State: Clinical and Functional Outcomes of Putatively Prodromal Youth Who Do Not Develop Psychosis

摘要: Background: The ‘‘clinical high risk’’ (CHR) construct was developed to identify individuals at imminent risk of developing psychosis. However, most identified as CHR do not convert psychosis, and it is unknown whether these nonconverting actually recover from an at-risk state. Methods: Eighty-four prospectively patients meeting criteria, 58 healthy comparison subjects were followed in a 2-year longitudinal study. Analyses examined rates conversion, clinical, functional recovery. Proportional cause-specific hazard models used examine the effects baseline time-varying predictors on conversion remission. Trajectories symptoms psychosocial functioning measures compared across outcome groups. Results: Competing survival analyses estimated that 30% psychosis by 2 years, while 36% symptomatically remit functionally years. Lower levels negative mood/ anxiety related increased likelihood both symptomatic who remitted more similar controls terms their than other Conclusions: Nonconverting cases represented heterogeneous group. Given nonconverted also presented initially with less severe prodromal symptomatology showed distinct normative trajectory over time, may be possible refine criteria reduce number ‘‘false positive’’ eliminating those present attenuated positive or show early improvements functioning.